Concussions and CTE: Why Football May Be America’s Next Public Health Crisis

Michael Galligan (’11)

In ancient Rome, within the walls of the Colosseum, gladiators would fight to the death in front of thousands of observers.  Crowds would boo and cheer, the mead flowed, and food was distributed.  The climax of these events would be the death or serious injury of one of the contestants.  If this type of event sounds familiar, it should.  However, our modern-day “gladiators” are professional athletes, and rather than fighting with swords, America’s gladiators play football.  As former NFL player Howie Long once said, “Baseball may be America’s pastime, but football is America’s passion.”  Every week in the fall, millions of Americans fill stadiums and tune in on television to watch their favorite high school, college and professional teams compete in a sport that President Teddy Roosevelt once considered banning because of its excessive violence.  While instant death on the football field is certainly not as common as it was in the Colosseum contests, recent research has shown that football may have serious, and sometimes fatal, long term consequences.

Owen Thomas had a bright future ahead of him.  A student at the Wharton School of Business at the University of Pennsylvania and the starting linebacker on the football team, Thomas tragically ended his own life in September 2010 at the age of 21.  An autopsy revealed that Thomas suffered from a progressive brain disorder called Chronic Traumatic Encephalopathy, or CTE, which was first discovered in the early twentieth century.  Doctors found that the disorder results from repetitive blows to the head, which is why doctors originally dubbed CTE “Punch-drunk Syndrome.”  The disorder is very much like Alzheimer’s Disease in that it causes deterioration of the brain including slurred speech, memory loss, and behavioral changes.  The doctors who preformed the autopsy on Thomas have said that, given the disease’s link to depression and impulse control, CTE might well have played a role in his suicide.  CTE was originally believed to be confined to former boxers.  However, recent autopsies of former football players, both professional and amateur, have indicated that there is a link between football and the disease.  These recent developments indicate that the “big hits” or even the normal “little hits” associated with football could lead to the development of this disorder.  This linkage is supported by a number of studies conducted on former NFL players.

In March of 2007, the University of North Carolina’s Center for the Study of Retired Athletes found that of the former NFL players who sustained three or more concussions on the field, 20.2% of them reported being diagnosed with depression.   In November 2009, the University of Michigan’s Institute for Social Research released a study of former NFL players that had disturbing findings.  The study found that of former NFL players over fifty, 6.1% had been diagnosed with dementia, Alzheimer’s Disease, or other memory-related diseases.  This percentage is five times higher than the national average for that age group.  The study further found that in players between the ages of thirty and forty-nine, the reported rates of dementia, Alzheimer’s Disease, or other memory-related diseases were nineteen times the national average.   These findings, compounded with our understanding that sustained multiple mild traumatic brain injuries (which are virtually unavoidable in football) have long-term consequences, suggests that the United States, which has approximately four-million high school and youth players, might be on the verge of a public health crisis.

In light of these new developments, the helmet industry has come under greater scrutiny.  The helmet industry is subject to no government or independent oversight.  Helmet manufacturers have no safety standards to meet.  The only standard in the industry is one provided by the National Operating Committee on Standards for Athletic Equipment, or NOCSAE.  The NOCSAE standard requires that both new and used helmets protect players against skull fractures.  However, this doesn’t necessarily prevent CTE; the force required to cause a player to sustain a concussion is significantly lower than the force required to cause a fractured skull. In January 2011, the NOCSAE announced that it would update its current standards, but thus far has not done so.  However, even if the NOCSAE were to update its current standards, most experts believe that no helmet can be developed to fully prevent concussions in football.

To make the game safer for players, there must be major changes to the game itself.  America cannot afford to wait for an entire generation of football players to develop the harsh long-term effects associated with the game.   While the game of football without concussions is currently inconceivable, a safer brand of football is.  The question that both football fans and policymakers need to answer now is, “How do we develop a game that doesn’t compromise the future health of its players?”

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